The most common fastener used in the reconstruction of bone fracture fragments in the human body is a screw. Screws of various types are used to directly hold bone fragments together, hold plates onto bone, and to act as anchors for the attachment of tendons and grafts of various types. Screws have certain disadvantages. In soft bone, they gain little purchase; in extremely thin bone, such as about the face, few threads gain purchase for adequate fixation. With the advent of extremely small bone plates for fracture and reconstructive surgical procedures, the screws are so small that just handling them and keeping them on a screwdriver can be difficult. Screws also require a significant amount of time to insert, especially if the hole has to be threaded first.
Various types of "blind" rivets are commonly used in industry. Most of them consist of two parts: a puller and the rivet body. The puller causes a deformation of the rivet body as it is moved in a linear direction. The expansion deformity of the rivet body continues until the expanded area reaches either the rivet head or the material into which the rivet is placed. These types of fasteners work well in sheet metal as the material has sufficient strength to resist further deformation of the rivet body and right fixation, as well as breakaway of the puller shaft is accomplished quite easily. Unfortunately, these designs do not work well in the human body, as bone is not strong enough to stop the progression of the widened rivet body before it contacts the rivet head.
The following patents relate to this subject matter: U.S. Pat. Nos. 1,105,105; 2,494,229; and 4,590,928.